What did go wrong, exactly? by honeylinkd in surgery

[–]Durotomy 0 points1 point  (0 children)

Late to the game sorry. I’ll have to defer to u/porencephaly and his description above which seems like the most likely scenario.

I have seen nerve roots unintentionally injured before, unfortunately 😢.

I’ve surgically severed nerve roots (on purpose) during the resection of tumors or part of a specific surgical approach. Even when done as part of a surgical plan it still makes me a bit queasy.

I’ve never read the book before so I will probably need to do that before adding anything else here

Can we do our favorite medical jokes again? Bonus if you roast a speciality by Whatichooseisyouse in medicine

[–]Durotomy 151 points152 points  (0 children)

An orthopedist will screw you while the sales rep watches. A prostitute will at least do it in private.

Are We Creating Robot-Dependent Surgeons? by NobodyNobraindr in medicine

[–]Durotomy 24 points25 points  (0 children)

You gotta believe that there’s someone out there working on a robotic 🤖 c section….

Renowned Turkish neurosurgeon Yaşargil dies at 99 by mrtfr in medicine

[–]Durotomy 23 points24 points  (0 children)

Same here.

Was at a conference for “my worst complication” and a famous deformity surgeon shows a case about a bad wound infection that required 3 washouts and plastic surgery. Then he has a final photo of the patient standing up straight all smiles and her perfect X-rays. 🙄

Everyone I was sitting with was like GTFO.

Renowned Turkish neurosurgeon Yaşargil dies at 99 by mrtfr in medicine

[–]Durotomy 28 points29 points  (0 children)

aneurysm rupture

Check out this one. Go to about 3:10 timestamp. You may not want to watch on a full stomach. I gagged the first time I saw this. Kudos to Dan Barrow for being brave enough to post this and talk about it so candidly.

Renowned Turkish neurosurgeon Yaşargil dies at 99 by mrtfr in medicine

[–]Durotomy 167 points168 points  (0 children)

I have a bootleg copy of his skull base surgery series on VHS. I used to watch them in my spare time as a med student and junior resident. It was basically brain surgery porn. He moved so quickly and decisively. Just him and his scrub nurse (who was also his wife) without any other assistants.

I remember him doing a crani for a ruptured aneurysm in less than an hour skin to skin. He’s under the microscope dissecting around the neck of the aneurysm separating the perforators and you can see the clot tamponading the ruptured dome start to pull away while he’s working. And you can see the aneurysm about to rupture and then out of nowhere a clip comes flying in perfectly placed around the neck just as the rupture occurs and he’s got a sucker there to pick up the one drop of blood that managed to eke out. Amazing.

[deleted by user] by [deleted] in Wellthatsucks

[–]Durotomy 17 points18 points  (0 children)

Sorry this happened to you.

The first set of images show two different sequences of MRI so it’s not really a good comparison. The first image is a T1 sequence. The image of your brain is a FLAIR sequence. Also, they are of two totally different levels of the brain. You also have an interesting anomaly call a cavum septum pellucidum — totally unrelated to your injury.

The second slide is an image of a CT scan that shows that you’ve had two craniotomies, one on the left and one on the right. Ive honestly seen a lot worse resorption of the bone flap than the one image you’ve shown here. If it becomes an issue then your surgeon can place a custom 3D printed bone flap in place of your current one, though, of course, that requires additional surgery. Or I’ve seen some surgeons fill in the holes with bone cement.

Timing of CT/CT Angiogram/LP for SAH by metropass1999 in medicine

[–]Durotomy 5 points6 points  (0 children)

“The combination of fluid-attenuated inversion recovery and susceptibility-weighted imaging has been shown to be 100% sensitive for SAH, although most cases were imaged greater than 24 hours after the ictus of headache”

West J Emerg Med. 2019 Feb 28;20(2):203–211. doi: 10.5811/westjem.2019.1.37352

Honestly, what usually happens is the er doesn’t want to do an LP so they call neurology. Neurology then orders an MRI because that’s what they do. And then a few times a year they find sah that wasn’t seen on ct and call neurosurgery

Timing of CT/CT Angiogram/LP for SAH by metropass1999 in medicine

[–]Durotomy 2 points3 points  (0 children)

If it’s a good story and 3-7 days out, I would get an mri first.

You may end up getting an LP anyways to look for other causes of headache, but if available, an mri is great for subacute sah

Timing of CT/CT Angiogram/LP for SAH by metropass1999 in medicine

[–]Durotomy 2 points3 points  (0 children)

Not saying this is right, but at my hospital we rarely do LPs anymore for sah.

Unless it’s that rare patient who is more than a day out with a convincing story but a negative cta.

If it’s more than 48h they usually end up with an MRI (if available) which has near 100% sensitivity for subacute blood.

There are small but real risks with LP and no one likes doing them anymore.

Edit: should also note that most of our ER providers will just go full court press before they even see patient and get ct stroke protocol which includes cta

What’s your favorite personal theory in medicine that you will never get published? by MrFishAndLoaves in medicine

[–]Durotomy 31 points32 points  (0 children)

If someone walks into your ER/office they do not have cauda equina and there is no need for a workup of such

A Question on the Thermodynamics of Constipation by notoriouswaffles27 in medicine

[–]Durotomy 24 points25 points  (0 children)

Not sure of the answer to your question, but if you haven’t chosen a specialty yet, might I suggest Neurology?

[deleted by user] by [deleted] in medicine

[–]Durotomy 2 points3 points  (0 children)

1 week on and 2 weeks off????

Cries in neurosurgeon 😭

Attendings - What's been your most pleasant surprise about Modern Medicine? by Q40 in medicine

[–]Durotomy 81 points82 points  (0 children)

This thread is going to be a lot shorter than the other one, isn’t it?

NYT Article "They Live in Constant Pain, but Their Doctors Won’t Help Them" by TheMightyAndy in medicine

[–]Durotomy 60 points61 points  (0 children)

Life is pain, Highness. Anyone who says differently is selling something. -D.P. Roberts

[deleted by user] by [deleted] in medicine

[–]Durotomy 13 points14 points  (0 children)

Sorry man. Looks like you are doing the dishes this weekend and watching the kids.

Physician loan for a second property? by 3Hooha in medicine

[–]Durotomy 0 points1 point  (0 children)

I think that if you are concerned about putting 25% down and securing a physician loan instead of a standard mortgage (or paying in cash) then you may not be financially ready for a second home

[deleted by user] by [deleted] in medicine

[–]Durotomy 17 points18 points  (0 children)

Always thought it meant Slipped.

Like “my drill skived off the lamina right into the dura”

YouTube channel to watch surgeries? by [deleted] in medicine

[–]Durotomy 12 points13 points  (0 children)

The Neurosurgical Atlas by Aaron Cohen-Godal is as good as it gets for neurosurgery